FS-2700-3e Special Use Application and Permit for Government Owned

Auth ID: #AUTH_ID#
Contact ID: #HOLDER_ID#
Expiration Date: #EXPIRATION_DATE#
Use Code: #USE_CODE#

FS-2700-3e (03/06)
OMB No. 0596-0082

USDA FOREST SERVICE
SPECIAL USE APPLICATION AND PERMIT
FOR
GOVERNMENT-OWNED BUILDINGS
Authority:
The Granger-Thye Act of April 24, 1950 (16 U.S.C. 572 and 580d)
Permission is hereby granted to:
Holder:

Address:

Auto Make:

Telephone:

License:

No. of People in Group:

No. of Pack or Saddlestock:

Other:

Snowmachines:

Hereinafter called the holder, to use subject to the conditions set out below, the following described Government-owned
National Forest:

Improvements located on the

FACILITY

# DAYS

FROM

TO

INSTRUCTIONS/RESTRICTIONS

Maximum party size is

Check out time is

THIS PERMIT IS ACCEPTED SUBJECT TO THE CONDITIONS SET FORTH HEREIN.
IN CONSIDERATION FOR SUCH PERMISSION, I AGREE TO ABIDE BY THE TERMS OF THIS PERMIT AND THE RULES FOR OCCUPANCY OUTLINED BY
THE AUTHORIZED OFFICERS, ATTACHED TO AND MADE A PART OF THIS PERMIT.

This permit is issued under the authority of the Granger-Thye Act of April 24, 1950. The holder agrees to pay a fee of
per day for a total of
perform necessary maintenance of the facility.

. The Forest Service, in accordance with the Granger-Thye Act, may use the fees to

Holder signature:

Date:

Authorized Officer
signature:

Date:

Terms and Conditions
1. This permit is non-refundable. Any changes to reserved dates must be made at least
reservation.

days prior to the original

2. The holder shall maintain the improvements and premise to standards of repair, orderliness, neatness, sanitation, and safety
acceptable to the Forest Officer in charge. (See attached Rules for Occupancy.)
3. The holder, in exercising the privileges granted by this permit, shall comply with the regulations of the Department of
Agriculture and all Federal, State, County and municipal laws, ordinances, or regulations which are applicable to the area of
operations covered by this permit.
4. The holder shall take all reasonable precautions to prevent and suppress wildfires. No material shall be disposed of by burning
in open fires during the closed season established by law or regulation without a written permit from the Forest Officer in charge or
his authorized acting.
5. The holder shall exercise diligence in preventing damage to the land and other property of the United States covered by, and
used in connection with this permit. The holder shall reimburse the United States for any damage of property, other than ordinary
wear and tear, caused by the holder related to the occupancy of the facilities and the use of other property under the terms of this
permit.
6. Avalanches, rising water, high winds, falling limbs or trees, and other hazards are natural phenomenon in the forest that
presents risks, which the holder assumes. The holder assumes the responsibility of inspecting the site and immediate adjoining
area for dangerous trees, hanging limbs, and other evidence of hazardous conditions and, after securing permission from the
Forest Service, or removing such hazards.
7. The holder shall pack out and properly dispose of refuse, and shall not discharge waste or refuse into surface waters.
8. In the event of emergency rescue involving the holder or any other parties involved in the use, which require helicopter
evacuation, the holder will be responsible for the cost of such rescue.
9. No fireworks shall be stored or used on the land covered by this permit, or in the structures thereon.
10. This permit shall not be exclusive. The Forest Service reserves the right to use or permit others to use any part of the
permitted area for any purpose, provided such use does not interfere with the rights and privileges hereby authorized.
11. The holder shall indemnify the United States against any liability for damage to life or property arising from the holder’s
occupancy or use of National Forest lands under this permit.
12. This permit is not transferable.
#INSERT TERM HERE#
Special Instructions/Restrictions:

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The valid OMB control number for this information collection is 0596-0082. The time required to complete this information collection is estimated to average 15 minutes per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual
orientation, and marital or family status. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large
print, audiotape, etc.) should contact USDA’s TARGET Center at 202-720-2600 (voice and TDD).
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, DC 20250-9410 or call (800) 975-3272 (voice) or (202) 720-6382 (TDD).
USDA is an equal opportunity provider and employer.
The Privacy Act of 1974 (5 U.S.C. 552a) and the Freedom of Information Act (5 U.S.C. 552) govern the confidentiality to be provided for information received by the Forest Service.